The CONTENT project: a problem-oriented, episode-based electronic patient record in primary care.

TL;DR: The Continuous morbidity registration Epidemiologic NeTwork (CONTENT) project as discussed by the authors is an ambitious project in Germany to establish a system for adequate medical data based on an appropriate data structure.

TL;DR: There is a big gap between guideline recommendation and actual prescribing, in the decision to prescribe and the choice of antibiotic agent, which could be closed by periodic quality circles on antibiotic prescribing for GPs.

TL;DR: Internal evidence and peer-group opinion are strong determinants for clinical decisions and a self-conducted practice test, together with self-reflection in a peer group, strongly supports the process of change in prescribing.

Abstract: Objectives Antibiotic overprescribing in primary care has major impacts on the development of antibiotic resistance. The objective of this study is to provide insight in antibiotics prescriptions for patients suffering from cough, acute bronchitis or community acquired pneumonia in primary care. Methods Data from 2009 to 2013 of electronic health records of 12,880 patients in Germany were obtained from a research database. The prescription of antibiotics for acute lower respiratory tract infections was compared to the national S3 guideline cough from the German Society of General Practitioners and Family Medicine. Results Antibiotics were prescribed in 41% of consultations. General practitioners’ decision of whether or not to prescribe an antibiotic was congruent with the guideline in 52% of consultations and the antibiotic choice congruence was 51% of antibiotic prescriptions. Hence, a congruent prescribing decision and a prescription of recommendation was found in only 25% of antibiotic prescriptions. Split by diagnosis we found that around three quarters of antibiotics prescribed for cough (73%) and acute bronchitis (78%) were not congruent to the guidelines. In contrast to that around one quarter of antibiotics prescribed for community acquired pneumonia (28%) were not congruent to the guidelines. Conclusions Our results show that there is a big gap between guideline recommendation and actual prescribing, in the decision to prescribe and the choice of antibiotic agent. This gap could be closed by periodic quality circles on antibiotic prescribing for GPs.

TL;DR: The objective in the project Integrated Primary Care Information was to assess whether the electronic patient records of Dutch general practitioners contain sufficient data to perform studies in the area of postmarketing surveillance studies, and to develop an organization to monitor the use of data.

TL;DR: Making evidence from scientific studies available to clinical practice has been expected to directly improve quality of care, but this expectation has not been realised and the knowledge base for family practice must be expanded by integration of multiple methods of comprehension, to bridge the gap between evidence and practice.

TL;DR: In this paper, an electronic version of ICPC-2, with all necessary corrections, is published on the Oxford University Press web site as a part of this article, which is specifically to be used in an electronic patient record and for research purposes.

TL;DR: In the absence of a patient list, a reliable denominator can be calculated, starting from the number of patients who contacted their GP in the period of one year, using a correction factor.